Side Effects of Antiepileptic Drugs Used in Children

Side Effects of Antiepileptic Drugs Used in Children with Epilepsy: A Systematic Review *Assist. Fatma Dilek TURAN GÜRHOPUR *Assoc. Prof. Ayşegül İŞLER DALGIÇ *AKDENİZ UNIVERSTY, NURSING FACULTY

Antiepileptic Drugs in Epilepsy Although there alternatives in the treatment of epilepsy, the primary treatment is antiepileptic drug (AED) treatment. However, AED treatment has side effects. This is more serious in children.

OBJECTIVE The objective of this systematic review was to determine the side effects of antiepileptic drugs used in children with epilepsy.

Meterial and Method Literature review has been limited to the last decade Akdeniz University elektronic databased in «Pubmed, Cinahl, Sciencedirect, Cochrane, Ulakbim Turkish Medical Directory, Turkish Medline» Screening was conducted between April and May 2017

Meterial and Method-II Using the keywords "children and antiepileptic drugs side effects", "children with epilepsy and antiepileptic side effects" 2339 articles have been reached. Of these, 1889 were duplications.

Meterial and Method-III Five randomised controlled studies were included in the systematic review that provided the research criteria as language, title, content that can be reached in full text.

RESULTS

The most frequent side effects in children who used antiepileptic drugs in the studies studied were; -Weight gain, -Body mass index and serum glucose levels, -Gingival problems, -Hearing problems and -High renal tubules were noted as disfunctions.

Hasaneen et al. (2016), there was no significant difference between anthropometric measurements, BMI and blood test and control groups when the results were compared. However, in the experimental group, it was determined that waist-to-hip ratio and neck significantly increased when severe weight loss and decrease in BMI were detected after 6 months of levetiracetam treatment compared to pre-treatment values.

Maksoud et al. (2016) did not show a statistically significant difference in terms of weight, height and BMI between the groups when the results were compared. However, the increase in weight and BMI at the 6 th and 1 st follow-ups of the experimental group was statistically significant. Serum calcium levels were not significantly different between the two groups, whereas serum glucose levels were found significantly higher in the 6 th month and 1 st year follow-up of the experimental group. Similarly, while the AST values in the experimental group did not differ across the follow-ups, ALT values increased significantly throughout the follow-up.

Suneja et al. (2016), Phenytoin has been reported to cause gingival hyperplasia. Sodium valproate has been reported to have gingival hyperplasia to clinically insignificant levels within six months, and carbamazepine has been described as a safe drug in children with gingival hyperplasia. There was no significant difference between mean plaque scores at baseline, at 3 months, and at 6 months in all three drug groups.

Mazaheri et al. (2011), there was no significant difference in renal dysfunction between the control group and the non-antiepileptic drug-initiated group. NAG activity, a finding of renal dysfunction, was found to be statistically significantly higher in the valproic acid group than in the two drug-free groups. The urinary NAG / Creatinine index was significantly higher in the carbamazepine-receiving group compared with the non-drug-treated group. However, when NAG / Cr indices were examined between two groups using drugs, the NAG / Cr index of children in the group receiving valproic acid was statistically significantly higher. In addition, plasma concentrations of other renal dysfunction were found to be statistically significantly higher in these two groups.

Vurucu et al. (2008) assessed their hearing function according to the results of BSİUP test, and stated that there was no statistically significant difference between the groups in terms of I, III, V and I-III, I-V interpeak latency values. When the patients with valproic acid and carbamazepine groups were compared with the control group in terms of BSIP wave and interpeak latency values, the patients with both valproic acid and carbamazepine groups were statistically significant in terms of BSIP pulse I, III, V and I-III, IV interpeak latencies was longer. However, there is no significant difference between the patients with valproic acid and carbamazepine groups in terms of baseline wave and interpeak latencies.

CONCLUSION The study results show that family and children should be informed about the definite side effects of antiepileptic drugs and awareness should be developed in this regard.

SUGGESTIONS Knowing the side effects of AEDs is very important because they are taken into account in deciding on the use of AEDs in the clinic and awareness should be set up in the families. It is proposed to systematize the drugs with definite side effects by standardization and to share these side effects with children and parents by a guide.

SUGGESTIONS However, when the family is informed about side effects of drugs, it should be explained how important epilepsy drug treatment is. Otherwise, many families may think that AEIs have more adverse side effects than treatment and that they are harmful to the child.

REFERENCES • • • Hasaneen, B. , Salem, N. A. , El Sallab, S. , Elgaml, D. , & Elhelaly, R. Body weight, body composition, and serum ghrelin in epileptic children receiving levetiracetam monotherapy. Egyptian Pediatric Association Gazette, 2016; 64(4), 154 -159. Maksoud, H. M. A. , El-Shazly, S. M. , & El Saied, M. H. Effect of antiepileptic drug (valproic acid) on children growth. Egyptian Pediatric Association Gazette, 2016; 64(2), 69 -73. Suneja, B. , Chopra, S. , Thomas, A. M. , & Pandian, J. A Clinical Evaluation of Gingival Overgrowth in Children on Antiepileptic Drug Therapy. Journal of clinical and diagnostic research 2016; 10(1), ZC 32. Mazaheri, M. , Samaie, A. , & Semnani, V. Renal tubular dysfunction measured by N-acetylbeta glucosaminidase/Creatinine activity index in children receiving antiepileptic drugs: a randomized controlled trial. Italian Journal of Pediatrics 2011; 37(1), 21. Vurucu, S. , Kesik, V. , Ünay, B. , Ulaş, Ü. H. , Odabaşı, Z. , & Akın, R. Uzun süreli antiepileptik ilaç tedavisinin beyinsapı işitsel uyarılmış potansiyelleri üzerine olan etkisi ve klinik önemi, 2008